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Handwriting Analysis Indicates Spontaneous Dyskinesias in Neuroleptic Naïve Adolescents at High Risk for Psychosis

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Recurrent autumnal psychosis.

P Joshi¹, A C Wicks, S K Munshi

¹Department of Medicine, Leicester General Hospital.

Postgraduate Medical Journal

|May 14, 2003

Summary

Acute confusional states in elderly patients often have treatable causes. This case highlights recurrent psychosis in an older adult due to Atropa belladonna (deadly nightshade) ingestion, emphasizing the need for thorough toxicological assessment.

Area of Science:

Geriatric Medicine
Toxicology
Psychiatry

Background:

Acute confusional states are common in older adults and frequently have identifiable, treatable causes.
Prompt diagnosis and management are crucial for effective treatment and prevention of recurrent episodes.
Toxicological assessments are vital in cases of unexplained acute psychosis.

Observation:

A case study involving an older patient presenting with recurrent episodes of acute psychosis.
The patient's symptoms were directly linked to the ingestion of Atropa belladonna, commonly known as deadly nightshade.
This highlights a specific, yet significant, potential cause of delirium in the elderly.

Findings:

Atropa belladonna contains anticholinergic compounds that can induce delirium and psychosis.

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Ingestion of deadly nightshade can precipitate acute confusional states and psychotic symptoms in susceptible individuals.

The recurrent nature of the episodes was attributed to repeated exposure or delayed clearance of the toxin.

Implications:

Clinicians should consider plant-induced toxicity, including Atropa belladonna, in the differential diagnosis of acute psychosis in older patients.
Thorough patient history, including potential environmental exposures and substance ingestion, is critical for accurate diagnosis.
Raising awareness of botanical toxins can improve patient outcomes and prevent iatrogenic harm.